Cardiac Arrest Because Of Covid-19 Is Heart Attack: Madras HC Directs Insurance Company To Disburse Insured Amount
The Madras High Court directed the ICICI Lambard Insurance Company to disburse the insured amount to a claimant observing that cardiac arrest because of Covid-19 is a heart attack.
The Court was hearing a Writ Petition filed by a woman after her insurance claim was repudiated by the company by the impugned order.
The bench of Justice G.K. Ilanthiraiyan observed, “Only because of Covid-19, he suffered with cardiac arrest and it is nothing but heart attack and the demise of the petitioner's husband is very much covered under the policy.”
Brief Facts-
The petitioner's husband took out two loans from the DCB Bank Ltd., with life insurance mandated for the loan amounts. The husband's life was insured with ICICI Lambard General Insurance Company Ltd. He died of cardiac arrest during the Covid-19 pandemic, with the cause of death recorded by doctors as cardiac arrest, without a postmortem. The petitioner N. Lakshmi filed a claim with the DCB Bank Ltd, which was denied because the cause of death was unverified without a postmortem and did not fall under covered medical conditions. The second respondent suggested the petitioner seek redress through the Insurance Ombudsman. Aggrieved by the same, the present petition was filed.
The Court noted that the occurrence of the first time of a heart attack of specified severity is covered under the policy.
The Court said that as held by the Supreme Court of India, the insurance company should not be too technical and act arbitrarily.
The Court further mentioned the decision in Jasmine Ebenezer Arthur Vs. HDFC ERGO General Insurance Company Ltd., & ors and observed, “even though law seems to be clear constituting a balance between the insuring party and insured, in reality, there is no equality between the two as the insurer is the richest corporation and the individual is an ordinary individual.”
The Court noted that in many cases, the individual has no legal knowledge about the ambiguous language used in the company's policy with an intention to waive them from the liability to pay the injured on happening of an agreed event.
As per the Court, many a times the companies willfully neglect reimbursing the insured, who instead of getting their amount from the company have to pay the Courts for getting their rights enforced.
Accordingly, the Court quashed the impugned order and allowed the Writ Petition.
Cause Title: N. Lakshmi v. IRDAI
Appearance:
Appellant: Adv. K.Suresh Babu
Respondent: Adv. M.B.Raghavan and Adv. B.Sivakallapan